Frominside.com

Only The Guilty Go Quietly To The Gallows.

BUSINESS AS USUAL'; THE CONTINUED KILLING OF ONE PRISONER
EVERY EIGHT DAYS BY THE MEDICAL SERVICES OF THE
CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATIONby Dave
Harrison

Richard D. Bess was sentenced to one-hundred-five-years-to- life, to be served within the California Department of Corrections and Rehabilitation ("CDCR"). Despite his lengthy sentence, Richard expected one day to be released into the loving arms
of his family. As a result of the gross lack of treatment, delays in treatment and mistreatment of his medical condition
by CDCR doctors, staff and other personnel, Richard was released from his sentence much earlier than expected, albeit not into the loving arms of his family, but into the eternal embrace
of a pine box. This is a true story of the CDCR's continued killing of one prisoner every eight days.

The CDCR's medical services have been under the control
of a federal receive for years. Indeed, federal judges found that the CDCR's medical care of its prisoners to be so deficient
as to offend the Eighth Amendment of the United States
Constitution; finding, e.g., that the CDCR kills one prisoner
every eight days as a result of inadequate medical care (defined as lack of treatment, delays of treatment and/or mistreatment of the serious medical needs of prisoners). In 2010, after years
of contentious litigation, a three-judge panel of federal judges
ordered the CDCR to reduce its massively overcrowded prisoner
population to a level where adequate medical care could be
provided (at one point the CDCR's prisoner population topped
200% of design capacity). Throughout the years of litigation the
CDCR ignored (the federal judges allowed the CDCR to ignore) over
seventy orders to upgrade and repair its inadequate medical
services, her lawyers arguing that one killing every eight days did not offend the Constitution and was a perfectly acceptable
rate of loss. Not surprisingly, the CDCR appealed the three-
judge panel's ruling to the United States Supreme Court. In
2011, the Supreme Court affirmed the panel's reduction ruling.
Nonetheless, the CDCR's killing of prisoners continues unabated.

Richard was an African-American, 57-years of age, with a
family history of cancer; all risk factors his doctors were fully
cognizant of. The first sign of trouble, blood in his urine, was noticed by Richard on 3 March, 2010. Richard immediately
sought medical attention. Absent trauma, which there was none
in this case, blood in the urine indicates either infection, cancer or both. Richard was seen by CDCR Doctor, D. Ralston,
who did not order any tests or other diagnostic procedure to
determine the cause of the blood in Richard's urine. Importantly,
no cytology (microscopic evaluation of urine that detects cancer
cells) was ordered. In standard CDCR medical practice -- no
tests or diagnostic procedure conducted -- Doctor Ralston
summarily dismissed the bloody urine as merely an infection,
at any rate "not emergent." In the months following, in which
Richard's urine continued to be more blood than urine (think
90-weight motor oil), CDCR Doctors, T. Campbell, C. Barber, G.
Hori and Ralston, each and every one, ignored the obvious signs of cancer; extant risk factors, incessant bloody urine,
antibiotics having no curative effect, wildly fluctuating (both
high and low out of range) red and white blood cell counts.
No doctor during those months bothered to order a single test
or diagnostic procedure to determine the actual cause of Richard's
bloody urine.

Not until September, 2010, six months since the first sign
of trouble, did Doctor Ralston wonder, perhaps as an afterthought,
whether Richard might have some affliction other than an
infection. Doctor Ralston put in an "urgent" (in CDCR parlance,
"urgent" means treatment within fourteen days) referral that
Richard be seen by a urologist. On 15 September, 2010, having
reviewed tomography scans taken of Richard's bladder, Doctor
Hori put in an "urgent" referral for a cystoscopy (visual
inspection of the bladder and urethra by looking through a flexible viewing tube). Doctor Hori did not get around to performing the cystoscopy until 14 October, 2010. Thereafter,
Doctor Hori informed Richard that cancerous tumors inside his
bladder were the cause of the bleeding; a diagnosis that came
seven months after the first sign of trouble. Doctor Hori
scheduled surgery to remove the cancerous tumbrs. The surgery, was once canceled/delayed then performed on 5 November,
2010. Tumor samples were taken and tested, establishing the
cancer to be high grade and aggressive. Six weeks later, on
12 December, 2010, another surgery was performed and additional
tumors removed. Not until 2 February, 2011, was Richard scheduled for six treatments, one treatment per week, of Bacillus
Calmette-Guerin ("BCG") (a substance that stimulates the body's
immune system). Due to myriad delays and other hindrances by
prison staff, the final treatment was not provided until 13 April,
2011, thus rendering the entire BOG treatment virtually worthless.
Bloody urine continued, along with related pains and suffering.
Yet another cystoscopy was scheduled, but then canceled/delayed
by medical staff so they could conduct an "inventory" in the medical department. Eight days later, Richard arrived for his
rescheduled appointment, only to be turned away due to another
so-called "inventory." Not until 9 June, 2011, did Doctor Hori
conduct the scheduled-re-rescheduled cystoscopy, then finding
cancerous tumors in six locations within the bladder. The cancer was progressing unhindered. On 17 June, 2011, Doctor Roni
conducted surgery to remove cancerous tumors. On 22 June, 2011,
the cancer was established, as before, to be high grade and
aggressive, and now suspicious for invasion of the bladder
muscle. Doctor Hori acknowledged that it was critical to
Richard's life that the cancer not be given time to penetrate
through the bladder muscle, to wit, escape the bladder and
metastasize throughout the body.

Followup evaluations by various doctors reaffirmed the life
and death nature of Richard's condition, hence the need for an
immediate cystectomy (removal of the bladder). Months came and
went, until September, 2011, when (unknown) personnel of the CDCR arranged for surgery -- incredibly, not for the necessary
cystectomy -- but an agonizing and totally useless transurethral
resection of bladder tumors (scrapping of the bladder walls to
remove tumors, as Doctor Hori had twice done), a procedure that
does nothing to slow the cancer's progress through the bladder
muscle (the procedure did, however, much to the delight of the
cancer, delay the cystectomy, thus allowing the cancer additional
time to escape the bladder, as well as generating hefty fees
for the doctors and supporting medical staff). Month after month,
the reports and notes of every doctor stated in the most emphatic
terms the life and death urgency that the cystectomy be performed
immediately -- before the cancer escaped the bladder. From June,
when the cystectomy was approved, through July, through August,
through September, through October, through November and into
December -- no cystectomy. The cancer was not idle all those
months, but continued its work boring through the bladder muscle.
On 4 January, 2012, Doctor Hon's notes stated the obvious: "bladder CA, muscle invasion, needs cystectomy. This has been
delayed." Doctor Hon's notes of 20 January, 2012, stated the
same, as did his notes of 17 February, 2012. The doctors all
knew, as did the (unknown) personnel of the CDCR tasked with
arranging the cystect'omy, that delay of that surgery would
directly result in Richard's death. They all knew, yet continued to delay, to deny Richard the surgery necessary to save his life.
Their decisions were thought out. Inaction would lead to
Richard's death. They chose inaction deliberately. In a court
of law, that is called premeditation.

Followup evaluations by various doctors reaffirmed the life
and death nature of Richard's condition, hence the need for an
immediate cystectomy (removal of the bladder). Months came and
went, until September, 2011, when (unknown) personnel of the CDCR arranged for surgery -- incredibly, not for the necessary
cystectomy -- but an agonizing and totally useless transurethral
resection of bladder tumors (scrapping of the bladder walls to
remove tumors, as Doctor Hori had twice done), a procedure that
does nothing to slow the cancer's progress through the bladder
muscle (the procedure did, however, much to the delight of the
cancer, delay the cystectomy, thus allowing the cancer additional
time to escape the bladder, as well as generating hefty fees
for the doctors and supporting medical staff). Month after month,
the reports and notes of every doctor stated in the most emphatic
terms the life and death urgency that the cystectomy be performed
immediately -- before the cancer escaped the bladder. From June,
when the cystectomy was approved, through July, through August,
through September, through October, through November and into
December -- no cystectomy. The cancer was not idle all those
months, but continued its work boring through the bladder muscle.
On 4 January, 2012, Doctor Hon's notes stated the obvious: "bladder CA, muscle invasion, needs cystectomy. This has been
delayed." Doctor Hon's notes of 20 January, 2012, stated the
same, as did his notes of 17 February, 2012. The doctors all
knew, as did the (unknown) personnel of the CDCR tasked with
arranging the cystect'omy, that delay of that surgery would
directly result in Richard's death. They all knew, yet continued to delay, to deny Richard the surgery necessary to save his life.
Their decisions were thought out. Inaction would lead to
Richard's death. They chose inaction deliberately. In a court
of law, that is called premeditation.

Initially, in March of 2010, Richard's risk of death from the cancer in five years was a mere 15 to 20%. As a result of
the decisions and failures of CDCR doctors D. Ralston, T.
Campbell, C. Barber and G. Hori to conduct rudimentary tests
or other diagnostic procedures to determine the cause of the
blood in Richard's urine, and as a direct result of the years
of delays by those doctors, staff and other (unknown) CDCR
personnel that provided the luxury of time so that the high grade
and aggressive cancer could escape the bladder, Richard's five
year risk of death rocketed to 80%. Indeed, after the colostomy
was performed, Richard was informed that there was nothing more
the doctors could do (it might be suggested that the doctors had done enough (damage) already). Richard was told he had six months to live. Richard died on 12 March, 2013.

The doctors named herein, staff and other (unknown) CDCR
personnel, were not simply negligent. They knew that blood in urine meant either infection, cancer or both. Once the cancer
was discovered to be boring through the bladder muscle they knew
that the need for a cystectomy was immediate and life-determinate.
But they did not care about Richard, a prisoner whose life was
merely a statistic (one prisoner every eight days killed by CDCR
medical services). They simply didn't care beyond putting in their eight hours and collecting their three-hundred-thousand
dollars a year. All the risk factors were present. The symptoms
obvious and life threatening. Richard was persistent, although
always courteous and amiable, in seeking medical care. But those doctors did nothing to determine the cause of Richard's bleeding,
and once the high grade and aggressive cancer was discovered,
they embarked on a course of cancellations and delays, with added
mistreatments. It was June, 2011, when the cancer was discovered
to have invaded the bladder muscle, thus the realization that
Richard's life was hanging by a thread to an immediate cystectomy.
Incredibly, it would be another eight months before CDCR medical
services could be bothered enough to schedule that surgery. Way
too long for Richard. They knew, yet chose not to act. The
choice not to act amounts to premeditated murder or, if you are
a federal judge or receiver, the unnecessary death of one prisoner
every eight days or, if you are an employee of the CDCR (or one of her lawyers) you express the killing of Richard as not
offending the Eighth Amendment of the United States Constitution,
perfectly acceptable, just business as usual.

As all prisoners within the CDCR know from daily observance, experience and suffering, nothing at all has changed within the
CDCR's medical services, the CDCR continues to purposefully kill
(at least) one prisoner every eight days as a result of inadequate
medical care.